How to Become a Registered Dietitian Nutritionist (RD/RDN)

One of the most frequently asked questions I receive is “how do you become an RD?”

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Whether you’re a high school or college student searching for what to study or someone looking to make a career change and be a second-career dietitian, the path to becoming a Registered Dietitian Nutritionist (RD/RDN) can be a confusing one, especially if you were not advised properly on the expectations.

Here’s a little background on me:

In high school, when I was touring and applying to colleges, I was interested in a career in forensic science and was looking to become a Biochemistry/Biotechnology major.

That lasted a year.

Fun fact: the average college student will change their major 3 times

After working in a biochemistry lab over the summer and a research assistant, I realized that, while I love math and science, I did not want to spend my life in a lab.

I reevaluated my interests and strengths and arrived at the conclusion that a career in nutrition would suit me best. I was fortunate enough that my university also offered a degree in Dietetics and I did not have to worry about transferring. I was also only one year in to my program and already had a good amount of the early coursework covered thanks to AP credit from high school and the college courses I had already taken. I had plenty of time to catch up.

Okay, back to the main topic…

To become a registered dietitian, you need to:

  1. Enroll in an accredited program at the bachelor’s or master’s degree level. The program director can help you determine which courses you need to take to meet requirements.
  2. Complete at least 1,200 supervised practical experience hours in an accredited internship. Some programs complete this at the same time as earning your degree. You may also be taking additional coursework during this time. Length, area of focus, and cost will vary.
  3. Take the Registered Dietitian exam. Pass it.
  4. Obtain licensure, if required by your state.
  5. Maintain credentials through continuing education.

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Programs

Not every school, and not every nutrition degree, is accredited by the Academy of Nutrition and Dietetics. There are two types of programs:  coordinated and didactic

Neither of these is superior to the other – all have met accreditation requirements. Different time frames, degrees, costs, locations, costs, etc. should all factor in to your decision-making process.

Coursework varies by program, but you can expect to take courses such as chemistry, biology, organic chemistry, biochemistry, anatomy, physiology, human nutrition, advanced nutrition, and psychology.

I attended Michigan State University where I earned by bachelor’s degree in Dietetics. This was a DPD program, which meant that I had to apply to, and be accept in to, a dietetic internship (DI).

All dietitians are nutritionists, but not all nutritionists are dietitians.

The Internship

This is the big kahuna. The bread and butter of becoming an RD, in my opinion. The application process alone is intense and highly competitive. Hopefuls apply through a centralized application portal and are matched to one program, or none. Everyone finds out their match at the same time – granted they can actually log on to the portal because it crashes. Every. Year.

WARNING: The match rate is ~50%, meaning that about half of those who apply are not matched with a program and must wait until the next matching round to apply again if they so choose, usually in 6-12 months (in April and November). If you have a good program director, and are flexible with your future plans, you may be able to snag an empty spot in a program who did not have very many applicants or who had matched applicants decline the position.

(Small note, some schools who also have an internship program in addition to the DPD may have early matching/acceptance policies in place for their current students – in this case, you would not apply to any other internships and you would know ahead of time if you were accepted or not.)

Several factors go in to the matching process. A high GPA (3.8+ was recommended to me), work and volunteer experiences, leadership positions in clubs or groups, personal statement, letters of recommendation, and a personal interview are usually involved. And you may still not get matched. Do NOT just apply to one program and cross your fingers. I applied to 4 and that was on the low end recommended, as I knew that I had a strong resume to draw from and the programs I applied to had a track record with accepting our graduate. THIS IS EXPENSIVE! Most internships require that you pay an application fee in addition to what you are paying the matching service.

There are currently 255 internship programs in the US with varying numbers of enrollment, cost, and program length. Typical programs run 6-12 months full-time, but like I said there are various options out there that are longer or part-time or distance.

Again, no program is superior to any other program as they all have met accreditation requirements.

Thought the application process was stressful? I’ll be honest with y’all. This will be worse. The majority of the time, you will feel like you know nothing and second-guess every decision. This is a hands-on learning experience where you learn the ins and outs of what it means to be a nutrition professional day-to-day and all the while you are being graded and evaluated by your preceptors.

This is also where you can spread your wings, ask a ton of questions without judgment, and get a better idea of what area of practice you might want to specialize in. Hated the foodservice rotation? You don’t have to work in school nutrition! Loved working at WIC? Maybe community nutrition is your thing! Obsessed with calculations and charting? Ask for more nutrition support and clinical nutrition opportunities!

You need to speak up! If there are experiences you want, you need to ask for them. If you want more responsibility, you need to step up and ask for it sometimes. Be clear at the start what expectations are for each rotation. Ask for feedback before the rotation ends – you may only be at a location for a week or 3 months and everything in between. If you do a good job and show interest and potential, this could mean a job offer. A good amount of my fellow interns received their first position because of the connections they made during their internship.

Realize that MOST of these internship are NOT PAID! You will actually be paying a tuition for most of these. Some interns are able to work outside of their internship hours. I don’t recommend it. Internship hours can vary from 40-80 hours per week between studying, time spent on-site, and completing assignments.

I attended Northern Illinois University where my internship was completed at the same time as a master’s degree in Nutrition & Dietetics. Because of this, it was a 2.5 year program and completion of my internship was contingent upon graduating with the advanced degree.

Also, you will probably cry. It’s OK. Let it out. We all do it.

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The Exam

Congrats! You passed your internship! Now here comes the next hurdle ready to make you want to scratch your eyes, tear your hair out, and cry at inappropriate moments… the RD exam.

I studied a few hours every day after my internship ended up until test day about a month later. Our internship gave us access to the Inman Review which was the only study material that I used to prepare. I wanted to take the exam as soon as possible. Paperwork took some time after completing my internship and I could not register until after all my information was verified.

I went through the Inman material 3 times – each time condensing down my notes and focusing more on the material that I did not feel confident in my mastery of. I also answered all of the practice exam questions to see what areas I was weak in and why I answered certain questions incorrectly.

To put it in perspective, I graduated December 12, 2015. I passed the exam January 9, 2016. Because the exam was taken on a computer, I knew my results immediately and did not need to wait for mailed results.

I cannot give details on what is included on the exam, and I know that the format and questions change every so often. Some questions are weighted more than others (you receive a scaled score at the end). You may need to memorize some equations. It’s stressful. It’s hard. The correct answer will not always be obvious. It’s designed that way. The system learns as you go. If you are answering easy questions correctly, it gives you more difficult ones. If you keep failing more difficult questions, you get more easy ones. That’s where the weighted question system comes in to play.

When I took it, you were given a minimum of 125 questions, of which not all are graded (some are used to see if they would make good future test questions), and up to 145 questions. I knew that if my test ended after 125 that I was probably in the clear and the system knew that I had mastered the content. I only had to answer 125 questions = I PASSED! While you have up to 2 1/2 hours, I have always been a fast test taker and you are more than welcome to finish before the time ends.

I learned that a lot of the material that I was stressing over not knowing or not memorizing every equation did not matter in the end because of the particular set of questions which I was presented with. Piece of advice – focus on the big picture stuff and not what the particular reference range values are for every blood test that exists.

The exam is another major added expense. It costs about $200 each time you take it. I know colleagues who took the exam multiple times before passing.

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Licensure

This will vary by state. Some states require certification or licensure. Some states do not. If you move you may not have to do anything extra to keep your licensure, in others you may have additional requirements. You will have to go by your individual state laws.

In my state of Ohio, I had to undergo a background check, submit an application, and now I pay an annual fee (oh, look, more hidden costs). Not much to it. Had I chosen to stay in my home state of Michigan, however, I would not have to do any of that as they do not have RD licensure laws.

Continuing Education

Registered Dietitians are required to submit 75 CPEUs per 5-year recertification period. A Professional Development Portfolio is constructed which helps you reflect on and assess your current and future professional learning needs and goals in order to develop a personalized Practice Competency Profile that indicates competencies and performance indicators relevant to your practice.

Commonly used activity types include lectures and seminars, authoring publications, and self-study activities. Unless an activity or a provider is accredited, it may not be accepted for credit.

As a member of the Academy of Nutrition and Dietetics (another cost!?), I receive the monthly Journal which contains continuing education quizzes related to the articles within. Between these and occasional free live webinars, I am not finding any problem attaining continuing education credits. Some opportunities are free. Some you must pay for. As long as you don’t leave everything to the end and keep your eyes open, you should be fine.

I hope that this quick overview was helpful and answered some questions you might have!
I would be happy to go in to more detail about my internship and time spent in college if you would like.

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